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Special Committee Investigating Deaths Under Anaesthesia (SCIDUA)

The Special Committee Investigating Deaths Under Anaesthesia (SCIDUA) reviews deaths which occur while under, as a result of, or within 24 hours following the administration of anaesthesia or sedation for procedures of a medical, surgical, dental or investigative nature.

It aims to identify any area of clinical management where alternative methods could have led to a more favourable result. SCIDUA has been reviewing anaesthesia-related deaths since 1960. Initially, the committee looked for errors of management, when the mortality was one in 3,500 cases and there were large numbers of children and pregnant women dying.

The advancement of safe practices in anaesthesia has made much of today’s surgery possible and has brought great benefits to patient safety. The estimated number of anaesthesia-related deaths occurring in fit and healthy patients is less than one in 500,000.

Overview

The SCIDUA is an expert committee appointed by the Secretary, NSW Health, under delegation by the Minister for Health. Its Terms of Reference are to subject all deaths occurring while under, as a result of, or within 24 hours after the administration of anaesthesia or sedation to peer review so as to identify any areas of clinical management where alternative methods could have led to a more favourable result.

Reporting of Deaths

The NSW Public Health Act 2010 requires the health practitioner who is responsible for the administration of the anaesthetic or sedative drug, where the patient died while under, or as a result of, or within 24 hours after the administration of an anaesthetic or sedative drug for a medical, surgical or dental operation or procedure, to report the death to the Secretary, NSW Health via the SCIDUA.

Review of cases

All reported deaths are individually reviewed by the 2- or 3-member triage sub-Committee, which can either classify the death as due to factors not falling under the control of the health practitioner or request further information from the reporting health practitioner, using the SCIDUA questionnaire below.

When the questionnaire is returned, information in this document is de-identified, copied and distributed to members of the Committee prior to its meetings. Cases are discussed at each meeting and classified using the nationally recognised Anaesthetic Mortality Classification.

A confidential reply by the Chair is sent to the health practitioner explaining the Committee's decision. The Committee reports annually to the Minister on the results of its deliberations. The Committee also provides aggregate data to the National Committee on Anaesthetic Mortality, triennially.